J Holist Nurs. 2001 Mar;19(1):57-70.The effects of shiatsu on lower back pain.Brady LH, Henry K, Luth JF 2nd, Casper-Bruett KK.SourceDrake University, USA.AbstractShiatsu, a specific type of massage, was used as an intervention in this study of 66 individuals complaining of lower back pain. Each individual was measured on state/trait anxiety and pain level before and after four shiatsu treatments. Each subject was then called 2 days following each treatment and asked to quantify the level of pain. Both pain and anxiety decreased significantly over time. Extraneous variables such as gender, age, gender of therapist, length of history with lower back pain, and medications taken for lower back pain did not alter the significant results. These subjects would recommend shiatsu massage for others suffering from lower back pain and indicated the treatments decreased the major inconveniences they experienced with their lower back pain.

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Am J Chin Med. 2010;38(1):1-14.Effect of acupressure and trigger points in treating headache: a randomized controlled trial.Hsieh LL, Liou HH, Lee LH, Chen TH, Yen AM.SourceDepartment of Rehabilitation, Kaohsiung Medical University, Taiwan. chenlin@ntu.edu.twAbstractThe efficacy of acupressure in relieving pain has been documented; however, its effectiveness for chronic headache compared to the muscle relaxant medication has not yet been elucidated. To address this, a randomized, controlled clinical trial was conducted in a medical center in Southern Taiwan in 2003. Twenty-eight patients suffering chronic headache were randomly assigned to the acupressure group (n = 14) or the muscle relaxant medication group (n = 14). Outcome measures regarding self-appraised pain scores (measured on a visual analogue scale; VAS) and ratings of how headaches affected life quality were recorded at baseline, 1 month after treatment, and at a 6-month follow-up. Pain areas were recorded in order to establish trigger points. Results showed that mean scores on the VAS at post-treatment assessment were significantly lower in the acupressure group (32.9+/-26.0) than in the muscle relaxant medication group (55.7+/-28.7) (p = 0.047). The superiority of acupressure over muscle relaxant medication remained at 6-month follow-up assessments (p = 0.002). The quality of life ratings related to headache showed similar differences between the two groups in the post treatment and at six-month assessments. Trigger points BL2, GV20, GB20, TH21, and GB5 were used most commonly for etiological assessment. In conclusion, our study suggests that 1 month of acupressure treatment is more effective in reducing chronic headache than 1 month of muscle relaxant treatment, and that the effect remains 6 months after treatment. Trigger points help demonstrate the treatment technique recommended if a larger-scale study is conducted in the future.

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Anesthesiology. 2003 Jun;98(6):1328-32.Auricular acupressure as a treatment for anxiety in prehospital transport settings.Kober A, Scheck T, Schubert B, Strasser H, Gustorff B, Bertalanffy P, Wang SM, Kain ZN, Hoerauf K.SourceDepartment of Anesthesiology and General Intensive Care, University Hospital of Vienna, Austria.AbstractBACKGROUND:Auricular acupuncture at the relaxation point has been previously shown to be an effective treatment for anxiety in the preoperative setting. The purpose of this prospective, randomized, blinded study was to determine whether auricular acupressure can reduce stress and anxiety during ambulance transport.METHODS:Patients who required ambulance transport secondary to medical conditions were randomized to receive auricular acupressure at the relaxation point (n = 17) or at a sham point (n = 19). A visual analog scale was used to assess state anxiety as well as patient anticipation of hospital medical treatment (estimated waiting period for treatment, anticipated pain during treatment, attitude toward the physicians, and treatment outcomes). These variables were assessed at baseline and on arrival to the hospital.RESULTS:Patients in the relaxation group reported significantly less anxiety than patients in the sham group on arrival to the hospital (visual analog scale mean +/- SD: 37.6 +/- 20.6 to 12.4 +/- 7.8 mm vs. 42.5 +/- 29.9 to 46.7 +/- 25.9 mm, respectively; P = 0.002). Similarly, patient perception of pain during treatment (mean visual analog scale +/- SD: 32.7 +/- 27.7 to 14.5 +/- 8.1 mm vs. 17.2 +/- 26.1 to 28.8 +/- 21.9 mm, respectively; P = 0.006) and treatment outcomes of their illnesses (mean visual analog scale +/- SD: 46.7 +/- 29.4 to 19.1 +/- 10.4 mm vs. 35.0 +/- 25.7 to 31.5 +/- 20.5 mm, respectively; P = 0.014) were significantly more positive in the relaxation group than in the sham group. No differences were found in the other variables assessed.CONCLUSION:It was concluded that auricular acupressure is an effective treatment for anxiety in prehospital emergency settings.

----------------------------------J Urol. 2007 Jul;178(1):160-4; discussion 164. Epub 2007 May 17.Auricular acupressure as a treatment for anxiety before extracorporeal shock wave lithotripsy in the elderly.Mora B, Iannuzzi M, Lang T, Steinlechner B, Barker R, Dobrovits M, Wimmer C, Kober A.SourceDepartment of Anesthesia and Intensive Care, Medical University of Vienna, Vienna, Austria.AbstractPURPOSE:Auricular acupuncture at the relaxation point has been shown to be effective treatment for anxiety. We hypothesized that auricular acupressure may decrease anxiety in elderly individuals who are transported by ambulance before receiving ESWL.MATERIALS AND METHODS:We enrolled 100 patients with renal calculi who were transported to the local hospital by special ambulance, accompanied by 2 paramedics. Paramedic 1 performed data collection, while paramedic 2 performed auricular acupressure in patients randomly assigned to a relaxation group and a sham treated group. Anxiety was measured using a visual analog scale score on a scale of 0 to 100 mm.RESULTS:Each group consisted of 50 patients with similar demographic characteristics. The relaxation group had significantly decreased anxiety scores upon arrival at the hospital and lower anticipation of pain scores (mean+/-SD 57.6+/-21.8 to 15.4+/-9.8 and 35.7+/-29.7 to 9.5+/-4.1 mm VAS) than the sham treated group (55.5+/-25.9 to 49.8+/-28.9 and 37.7+/-24.1 to 33.8+/-25.2 mm VAS, respectively, 2-way repeated measure ANOVA each p=0.001). Estimated waiting times for treatment did not differ significantly between the 2 groups (5.0+/-2.5 and 5.5+/-2.95, respectively, repeated measures ANOVA p=0.83). The Post-Intervention Anxiety visual analog scale demonstrated the significant superiority of the true treatment group (19.5+/-5.9 and 66.8+/-27.9 mm VAS, respectively, p=0.001).CONCLUSIONS:Elderly patients who received auricular acupressure at specific relaxation points while being transported to the hospital were less anxious, anticipated less pain and were more optimistic about the outcome of treatment that they will receive than the sham treated group. These data prove that this is an effective treatment for anxiety that improves the patient overall perception of ESWL.

---------------------------BMJ. 2006 Mar 25;332(7543):696-700. Epub 2006 Feb 17.Treatment of low back pain by acupressure and physical therapy: randomized controlled trial.Hsieh LL, Kuo CH, Lee LH, Yen AM, Chien KL, Chen TH.SourceInstitute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.AbstractOBJECTIVE:To evaluate the effectiveness of acupressure in terms of disability, pain scores, and functional status.DESIGN:Randomised controlled trial.SETTING:Orthopaedic clinic in Kaohsiung, Taiwan.PARTICIPANTS:129 patients with chronic low back pain.INTERVENTION:Acupressure or physical therapy for one month.MAIN OUTCOME MEASURES:Self administered Chinese versions of standard outcome measures for low back pain (primary outcome: Roland and Morris disability questionnaire) at baseline, after treatment, and at six month follow-up.RESULTS:The mean total Roland and Morris disability questionnaire score after treatment was significantly lower in the acupressure group than in the physical therapy group regardless of the difference in absolute score (- 3.8, 95% confidence interval - 5.7 to - 1.9) or mean change from the baseline (- 4.64, - 6.39 to - 2.89). Acupressure conferred an 89% (95% confidence interval 61% to 97%) reduction in significant disability compared with physical therapy. The improvement in disability score in the acupressure group compared with the physical group remained at six month follow-up. Statistically significant differences also occurred between the two groups for all six domains of the core outcome, pain visual scale, and modified Oswestry disability questionnaire after treatment and at six month follow-up.CONCLUSIONS:Acupressure was effective in reducing low back pain in terms of disability, pain scores, and functional status. The benefit was sustained for six months.

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Altern Ther Health Med. 2009 Sep-Oct;15(5):44-6.Shiatsu as an adjuvant therapy for schizophrenia: an open-label pilot study.Lichtenberg P, Vass A, Ptaya H, Edelman S, Heresco-Levy U.SourceDepartment of Psychiatry, Herzog Memorial Hospital, Jerusalem, Israel.AbstractCONTEXT:Studies have suggested a possible role for shiatsu in treating a variety of mental and physical ailments.OBJECTIVE:To determine if shiatsu can provide clinical benefit to individuals diagnosed with schizophrenia.DESIGN:An open-label pilot study.SETTING:An inpatient psychiatric ward at Herzog Memorial Hospital, Jerusalem, Israel.PATIENTS:Twelve hospitalized patients with chronic schizophrenia.INTERVENTION:Shiatsu treatment provided in a course of eight 40-minute biweekly sessions over 4 weeks.MAIN OUTCOME MEASURES:All subjects were evaluated at baseline, 2 weeks, 4 weeks (end of treatment), and 12 weeks (followup). The tools used for assessment included the Clinical Global Impression (CGI), the Brief Psychiatric Rating Scale (BPRS), the Positive and Negative Syndrome Scale (PANSS), the Hamilton Rating Scale for Depression (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE). Side effects were measured using the Simpson-Angus Scale for Extrapyramidal Symptoms (SAS) and the Abnormal Involuntary Movement Scale (AIMS).RESULTS:On all scales of psychopathology and side effects, the subjects showed a statistically and clinically significant improvement by the end of treatment. This improvement was maintained at the 12-week follow-up. These findings, while encouraging, must be considered preliminary and require confirmation and cross-validation in larger-scale controlled studies.

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Complement Ther Nurs Midwifery. 1995 Apr;1(2):51-8.The role of shiatsu in palliative care.Stevensen C.SourceRoyal London Homoeopathic Hospital NHS Trust, London, UK.AbstractShiatsu is a form of Japanese massage, working on the meridian system of the body; the energetic pathways along which the acupuncture points are placed. The theory for shiatsu is based in the system of traditional Chinese medicine, understood in China for over 2000 years. Shiatsu can be valuable for reintegrating the body, mind and spirit, helping with the general energy level of the body as well as specific symptoms. Its role in western palliative care is little studied to date. This paper explores the potential benefits of shiatsu in this setting and cites a case example where it has been beneficial. Feelings of deep relaxation, support and increased vitality are common following a shiatsu treatment. The method, strength and frequency of treatment can be varied to suit individual need. Shiatsu should be considered when thinking of complementary methods of support in palliative care.

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Anesth Analg. 2002 Sep;95(3):723-7, table of contents.Prehospital analgesia with acupressure in victims of minor trauma: a prospective, randomized, double-blinded trial.Kober A, Scheck T, Greher M, Lieba F, Fleischhackl R, Fleischhackl S, Randunsky F, Hoerauf K.SourceDepartment of Anesthesia and Intensive Care, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.AbstractUntreated pain during the transportation of patients after minor trauma is a common problem in emergency medicine. Because paramedics usually are not allowed to perform invasive procedures or to give drugs for pain treatment, a noninvasive, nondrug-based method would be helpful. Acupressure is a traditional Chinese treatment for pain that is based on pain relief followed by a short mechanical stimulation of specific points. Consequently, we tested the hypothesis that effective pain therapy is possible by paramedics who are trained in acupressure. In a double-blinded trial we included 60 trauma patients. We randomly assigned them into three groups ("true points," "sham-points," and "no acupressure"). An independent observer, blinded to the treatment assignment, recorded vital variables and visual analog scales for pain and anxiety before and after treatment. At the end of transport, we asked for ratings of overall satisfaction. For statistical evaluation, one-way analysis of variance and the Scheffé F test were used. P < 0.05 was considered statistically significant. Morphometric and demographic data and potential confounding factors such as age, sex, pain, anxiety, blood pressure, and heart rate before treatment did not differ among the groups. At the end of transport we found significantly less pain, anxiety, and heart rate and a greater satisfaction in the "true points" groups (P < 0.01). Our results show that acupressure is an effective and simple-to-learn treatment of pain in emergency trauma care and leads to an improvement of the quality of care in emergency transport. We suggest that this technique is easy to learn and risk free and may improve paramedic-based rescue systems. IMPLICATIONS: We tested, in a double-blinded manner, the hypothesis that acupressure could be an effective pain therapy in minor-trauma patients. Our results show that acupressure is an effective and simple-to-learn treatment of pain in emergency medical care and can improve the quality of care.